title: A resorbable shape-memory starch-based stent for the treatment of salivary ducts under sialendoscopic surgery.
abstract: OBJECTIVE
  In sialendoscopy, stents are often used to keep the salivary duct open after surgery. These stents need to be removed. Recently, our group developed a new starch-based shape-memory material that is a widespread degradable polymer. Such a device could be manufactured into a deployable resorbable stent to keep the salivary duct open before in situ degradation. An experimental test was performed to establish a methodology and to evaluate the feasibility of the starch stent implantation in an animal model with clinical equipment.
  
  
  METHODS
  Evaluation of different formulations-potato and high amylose content maize starch without and with plasticizer-with laboratory bench-top testing and in vivo evaluation in a large-animal model.
  
  
  METHODS
  Starch-based stents were manufactured. They were evaluated for their shape-memory properties (water, 37°C) and their degradability in simulated saliva in both static and flow conditions mimicking salivary flow in the submandibular duct. A pilot study of stent implantation was then performed in vivo in a large-animal model to assess that the stent dimensions were consistent for implantation in the submandibular duct.
  
  
  RESULTS
  Stents made from plasticized starch had the required shape-memory properties to be used as self-deploying stents. However, starch-based stents were rapidly hydrolyzed in simulated saliva. Stents could be directly inserted in the dilated salivary duct in a pig model without harming the epithelium.
  
  
  CONCLUSIONS
  Shape-memory stents with suitable geometry for sialendoscopic surgical procedure can be fabricated and inserted in the submandibular duct. Starch-based stents can be used in other pathologies with less α-amylase content in the surrounding medium.
  
  
  METHODS
  NA.
authors.affiliation: INRA, UR1268, Unité Biopolymères Interactions et Assemblages, Nantes, France; European Sialendoscopy Training Center, Clinique Générale Beaulieu, Geneva, Switzerland.
authors.forename: Anne
authors.initials: A
authors.lastname: Beilvert
authors.forename: Frédéric
authors.initials: F
authors.lastname: Faure
authors.forename: Anne
authors.initials: A
authors.lastname: Meddahi-Pellé
authors.forename: Laurent
authors.initials: L
authors.lastname: Chaunier
authors.forename: Sophie
authors.initials: S
authors.lastname: Guilois
authors.forename: Frédéric
authors.initials: F
authors.lastname: Chaubet
authors.forename: Denis
authors.initials: D
authors.lastname: Lourdin
authors.forename: Alain
authors.initials: A
authors.lastname: Bizeau
mesh_terms: D020341:Absorbable Implants; D000818:Animals; D004195:Disease Models, Animal; D004724:Endoscopy / Q000379:methods*; D005240:Feasibility Studies; D008422:Materials Testing; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods*; D011474:Prosthesis Design; D018987:Salivary Ducts / Q000601:surgery*; D013213:Starch; D015607:Stents; D013363:Submandibular Gland / Q000601:surgery*; D013364:Submandibular Gland Diseases / Q000601:surgery; D013552:Swine
chemical_list: D013213:Starch
keywords: Biopolymers; polysaccharides; shape memory; sialendoscopy; starch; stent; submandibular duct